Herb use and necrodegenerative hepatitis

Twelve patients with herbally-induced hepatitis are described and the clinicopathological features of their illness, which seem to present a recognisable spectrum, are discussed. The nature and the severity of the histological changes seem to correlate with the clinical manifestations and the immediate prognosis. Laboratory tests, especially liver function studies, are of limited diagnostic and prognostic value. The plants which contain the responsible toxins, have been identified in this country and in other parts of Southern Africa. A short list is provided of, apparently, the commonest medicinal plants in Lesotho. Many more toxic plants, however, are used in food and in diverse traditional medications. Senecio species are the principal source of hepatotoxic alkoloids, especially pyrrolizidines. Experimental studies ann evidence of similar disorders in animals, have thrown some light on the pathogenic mechanisms of these hepatotoxic and possibly hepatocarcinogenic agents. The disease in humans probably results from a combination of factors.